Robati Reza M, Moeineddin Fatemeh, Almasi-Nasrabadi Mina
Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Skin and Stem Cell Research Center, Tehran University of Medical Science, Tehran, Iran.
Aesthet Surg J. 2018 Jul 13;38(8):883-888. doi: 10.1093/asj/sjy005.
As the number of patients using dermal filler for face augmentation increases, the number of adverse events associated with injection may increase. Unpredictable repositioning of blood vessels and a more tenuous blood supply in the operated nose may increase the risk of ischemia, necrosis, and vascular embolism following the filler injection.
To highlight the importance of the patient's history of previous cosmetic procedures including rhinoplasty in the emergence of vascular complications.
Our medical records over a two-year period were reviewed retrospectively to identify all patients who were treated at our center for vascular complications associated with facial hyaluronic acid filler injections. In each case, the subject's demographic data (gender and age), habitual status, past medical and surgical history, the symptoms and clinical presentation at the first visit, the time interval between the injection and the onset of symptoms, injected filler material and brand, injection sites, the introduced treatment, and photographs were reviewed carefully.
A total of seven patients were identified, each developing skin necrosis following injection of the hyaluronic acid filler. All patients reported a cosmetic rhinoplasty more than three years ago.
Our finding confirms the conjecture previously made in the literature and suggests that the distinctive vascularity of the nose and the surrounding area may cause filler augmentation induced vascular complications in patients whose vascular circulation has already been compromised by a previous nose surgery.
随着使用真皮填充剂进行面部填充的患者数量增加，与注射相关的不良事件数量可能会上升。手术鼻部血管的不可预测重新定位以及更脆弱的血液供应可能会增加填充剂注射后缺血、坏死和血管栓塞的风险。
强调包括隆鼻术在内的患者既往美容手术史在血管并发症发生中的重要性。
回顾性分析我们中心两年期间的病历，以确定所有因面部透明质酸填充剂注射相关血管并发症接受治疗的患者。在每个病例中，仔细审查受试者的人口统计学数据（性别和年龄）、习惯状态、既往病史和手术史、首次就诊时的症状和临床表现、注射与症状出现之间的时间间隔、注射的填充材料和品牌、注射部位、所采用的治疗方法以及照片。
共确定7例患者，均在注射透明质酸填充剂后发生皮肤坏死。所有患者均报告三年多前接受过隆鼻术。
我们的发现证实了文献中先前提出的推测，并表明鼻子及周围区域独特的血管分布可能会在血管循环已因先前鼻部手术而受损的患者中导致填充剂填充引起的血管并发症。
